How safe are intramedullary stainless-steel nails for long bone fractures?

  • Sumeet Singhal Orthopaedic Surgeon & Director Dr. K. C. Singhal Hospital and Research Centre, Kwarsi, Ramghat Road, Aligarh-202001
Keywords: long bone fractures, intramedullary stainless-steel nails

Abstract

Femoral and tibial fractures are usually the result of high-energy trauma such as road traffic accidents, fall from heights and trauma in high-speed contact sports. Most femoral and tibial shaft fractures are treated surgically. Several studies have shown that early surgical stabilization is associated with reduction of complications and mortality. An intramedullary nail is a metal rod that is inserted into the medullary cavity of a bone and across the fracture in order to provide a solid support for the fractured bone. Intramedullary nailing is currently considered the “gold standard” for treatment of femoral and tibial shaft fractures. Proposed advantages of intramedullary nailing include short hospital stay, rapid union of the fracture and early functional use of the limb. Intramedullary nailing aims to preserve the anatomical structure of fracture site and to provide a proper environment for fracture healing. The present case report further enlightens the safe use of Intramedullary nailing for long bone fracture.

 

 

Author Biography

Sumeet Singhal, Orthopaedic Surgeon & Director Dr. K. C. Singhal Hospital and Research Centre, Kwarsi, Ramghat Road, Aligarh-202001

 

 

References

1. Smith-Petersen H N: Intracapsular fractures of neck of the femur. Treatment by internal fixation Arch Surg. 1931; 23:715-59.
2. Fakhry S M, Rutledge R, Dahners L E, Kessler D Incidence, management and outcome of femoral shaft Fracture: A statewide population-based analysis of 2805 adult patients in a rural state Journal of Trauma-Injury infection & Critical care 1994;37(2):255-60
3. Rudolff M I, Smith W R Intramedullary nailing of femur: current concepts concerning reaming Journal of Orthopedic Trauma 2009;23(5 suppl):S 12-7
4. Winquist R A, Hansen S T Jr, Clawson D K. Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases. Journal of Bone & Joint surgery- American volume 1984;66(4):529-39
5. Johnson N A, Cuzoigwe, Venkatesan M, Burugula V, Kulkarni A, Davison J N and Ashford R U. Risk factors for intramedullary nail breakage in proximal femoral fractures: a 10-year retrospective review Ann R Coll Surg Engl 2017, Feb; 99(2): 145-150.
6. Budinger L, Hertl M Immunologic mechanism in hypersensitivity reactions to metal ions: an overview. Allergy 2000;55:108-115
7. Swierczynska-Machura D, Kiec-Swierczynska M, Krecisz B, Palczynski C. Allergy to components of implants. Allergy Asthma immunolog;2004,9(3):128-132
8. Kanerva L, Forstrom L Allergic nickel and chromate- hand dermatitis induced by orthopedic metal implant. Contact Dermatitis 2001; 44: 103-104.
9. Brown S A, Devine S D, Herriti k. Metal allergy: metal implants and fracture healing. Biomater Medical devices. Artif Organs1983;11:73-81
10. David J Hak, Toker Chengla Yi, Jeffrey Toreson. The influence of fracture fixation biomechanics on fracture healing. The Trauma update 2010; 33(10): 752-755.
11. Shah A, Parikh V, Gandhi Vimla.Titanium v/s stainless steel interlocking nails: A comparative study of compound fractures of tibial shaft. Nat J Clin Ortho 2018; 2(4): 165-169
12. Bucholz R W, Ross S E, Lawrence K L. Fatigue fracture of distal part of femoral shaft. J Bone and Joint Surg 1987. 69: 1391-1399.
13. Bhat A K, Rao S K, Bhaskaranand K. Mechanical failure in intramedullary interlocking nails. Orthop Surg 2006; 14(2):138-141
14. Pan K L. Symptoms indicating imminent breakage of femoral interlocking nail: A case report. Malays Orthop J 2013 Nov; 7(3): 21-23.
15. Angel Perez, Andrew Mahar, Charles negus, Peter Newton, Tom impelluso. Computational evaluation of the effect of intramedullary nail material properties on the stabilization of simulated femoral shaft fractures. Med Eng Phys 2008, 30(6): 755-60.
Published
2020-12-31